Dog & Cat HospitalCalabasas

Patient Education

Colopexy

Colopexy permanently tacks the colon to the abdominal wall, preventing the rectum from prolapsing again after it has been manually reduced.

Colopexy is a surgical procedure that attaches the descending colon to the inner wall of the abdomen, creating scar tissue that anchors it in place. It is most often performed in dogs and cats that have had a rectal prolapse — a condition in which the inner layers of the rectum evert and protrude through the anal opening. While a first-time prolapse can sometimes be manually reduced (pushed back in), recurrence is common without a structural fix. Colopexy provides that fix by preventing the colon and rectum from sliding out of normal position again. Dr. Alan Schulman performs the procedure at Dog & Cat Hospital Calabasas alongside addressing whatever underlying cause triggered the initial prolapse.

Why It's Recommended

Colopexy is recommended when a rectal prolapse has recurred or when the tissue is too fragile or desiccated (dried) to reduce manually without risk of rupture. The underlying cause of the prolapse — such as intestinal parasites, colitis, perineal hernia, or urogenital disease — must also be identified and treated; colopexy alone will not prevent re-prolapse if the straining that caused the problem continues unchecked. Combined with cause-directed treatment, the procedure significantly reduces the likelihood of another prolapse episode.

How the Procedure Works

Colopexy is performed under general anesthesia. Steps of the procedure:

  • The abdomen is opened via a midline incision and the colon is identified
  • A small area of the outer surface of the descending colon is roughened (scarified) using a scalpel blade or electrocautery to promote adhesion
  • The matching area of the left lateral abdominal wall is similarly prepared
  • The colon is sutured to the abdominal wall using durable absorbable sutures; as healing occurs, fibrous tissue forms a permanent attachment
  • The abdomen is closed routinely

If the prolapsed tissue is non-viable (necrotic), an amputation of the prolapsed segment may be performed instead of or in addition to colopexy — the approach is decided at the time of surgery based on tissue condition.

Rectal prolapse in your dog or cat?

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Preparation

Pre-operative preparation includes fecal testing to detect and treat any parasites contributing to tenesmus (straining), abdominal radiographs or ultrasound to evaluate the colon and surrounding structures, and standard bloodwork. For animals that are young, debilitated, or have been straining for an extended period, correcting fluid and electrolyte imbalances before anesthesia is a priority. Food is withheld for eight to twelve hours before the procedure. The colon is gently cleaned where feasible.

Recovery & Aftercare

Most pets are discharged one to two days after surgery and recover steadily at home:

  • Days 1–5: soft, easily digestible food to reduce straining; pain medication; e-collar to protect the incision
  • Weeks 1–3: stool softeners are often continued to prevent hard stools that could stress the repair
  • Week 2–3: suture recheck and removal; gradual return to normal diet as stool consistency normalizes

The underlying cause of the prolapse — parasites, colitis, perineal hernia — must be addressed concurrently, otherwise straining will persist and the repair may be stressed. The team will provide a specific management plan tailored to the pet's situation.

Risks & What to Expect

Colopexy is generally well tolerated. Possible complications include seroma (fluid pocket) at the incision, infection, or — rarely — inadvertent constriction of the colon lumen. There is a small risk of continued prolapse if the underlying straining cause is not fully controlled, which underlines the importance of concurrent medical treatment. In cases where non-viable tissue required amputation, the anastomosis site carries the same small risk of leakage as any colonic repair. All risks are discussed before surgery so owners can make a fully informed decision.

Frequently Asked Questions

1How long does recovery take after a colopexy?
Most pets are back to normal activity within two to three weeks. The internal colopexy site takes four to six weeks to fully scar, so stool softeners and a soft diet are continued throughout to minimize straining on the repair.
2Can a rectal prolapse heal on its own without surgery?
A first prolapse can sometimes be manually reduced and held in place temporarily, but recurrence is common without surgical anchoring. If the underlying cause is not identified and treated, prolapse will likely recur regardless of whether surgery is performed.
3What causes rectal prolapse in cats and dogs?
Rectal prolapse is caused by any condition that makes a pet strain repeatedly — intestinal parasites, severe diarrhea or colitis, perineal hernia, urinary obstruction, and dystocia (difficult birth) are common triggers. Treatment must address the root cause as well as the prolapse itself.
4Is colopexy painful for my pet?
Pets receive multimodal pain management during and after surgery and are typically more comfortable than they were while straining repeatedly before surgery. Most owners report their pet seeming significantly more at ease within a few days.
5Will my pet be able to defecate normally after colopexy?
Yes — colopexy anchors the colon to the body wall without narrowing its interior, so normal stool passage is maintained. A soft diet and stool softeners during recovery help protect the repair in the early weeks.
6How much does colopexy cost for a dog or cat?
Cost depends on the animal's size, the need for concurrent procedures (such as treatment of a perineal hernia or necrotic tissue resection), and length of hospitalization. A detailed estimate is provided at the pre-operative consultation.
7What happens if a rectal prolapse is left untreated?
An untreated prolapse leads to progressive swelling, tissue desiccation, and eventually necrosis (tissue death) of the everted bowel segment, requiring emergency surgery or amputation. Early treatment is strongly preferred.
8What is the difference between colopexy and rectal prolapse amputation?
Colopexy anchors the healthy bowel internally to prevent re-prolapse; it does not remove tissue. Amputation (resection) removes a segment of non-viable prolapsed tissue and is chosen when the bowel wall is too damaged to reduce. Sometimes both techniques are combined.

Rectal prolapse in your dog or cat?

Early evaluation gives us the best options. Dr. Schulman and our care team will assess your pet, identify the underlying cause, and recommend the most appropriate repair.

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